Pinto da Cunha Nazaré, Ghisleni Gabriele, Scarampella Fabia, Fabbrini Fabrizio, Sforna Monica, Cornegliani Luisa, Caniatti Mario, Avallone Giancarlo, Moore Peter, Roccabianca Paola
Department of Veterinary Sciences and Public Health, University of Milan, Milan, Italy.
Vet Clin Pathol. 2014 Sep;43(3):428-36. doi: 10.1111/vcp.12152. Epub 2014 May 12.
Feline Progressive Histiocytosis (FPH) is a cutaneous dendritic cell neoplasm characterized by slow progression and spread to internal organs in the terminal stage. FPH is often misdiagnosed as an inflammatory reaction and has not been fully characterized from a cytologic diagnostic perspective.
The purpose of the study was to characterize the cytologic and immunocytochemical aspects useful for FPH diagnosis.
Fine-needle aspiration cytologic samples of 5 cases of FPH confirmed by skin biopsy and necropsy were evaluated. Immunocytochemistry with antibodies recognizing CD1a, CD1c, CD3, CD11b, CD18, CD21, and MHCII was performed on air-dried, acetone-fixed smears. E-cadherin expression was assessed on paraffin-embedded skin biopsies. Transmission electron microscopy (TEM) was performed in one case.
Main cytologic findings on variably cellular samples were characterized by single to cohesive large, round to polygonal cells with intermediate to low N/C ratio, abundant clear homogeneous cytoplasm, and round to oval nuclei with rare bi- to multinucleated atypical cells, associated with low numbers of small lymphocytes and/or neutrophils. Neoplastic cells expressed CD1a, CD1c, CD11b, CD18, and MHCII. Anti-CD3 antibodies identified reactive T cells admixed with the neoplastic cells. E-cadherin expression was observed in all but one case. TEM failed to identify Birbeck granules in one case.
FPH is a distinctive neoplastic lesion composed of nonphagocytizing histiocytes variably admixed with neutrophils and small mature lymphocytes. Immunocytochemical analysis with CD1 is mandatory to confirm a dendritic cell origin. Immunocytochemistry and cytomorphology allowed the specific and rapid diagnosis of FPH on cytologic samples.
猫进行性组织细胞增多症（FPH）是一种皮肤树突状细胞肿瘤，其特征为进展缓慢，在终末期会扩散至内脏器官。FPH常被误诊为炎症反应，从细胞学诊断角度来看，其特征尚未完全明确。
本研究旨在明确有助于FPH诊断的细胞学和免疫细胞化学特征。
对5例经皮肤活检和尸检确诊的FPH病例进行细针穿刺细胞学样本评估。在空气干燥、丙酮固定的涂片上，使用识别CD1a、CD1c、CD3、CD11b、CD18、CD21和MHCII的抗体进行免疫细胞化学检测。在石蜡包埋的皮肤活检样本上评估E-钙黏蛋白的表达。对1例病例进行透射电子显微镜（TEM）检查。
不同细胞数量样本的主要细胞学表现为单个至聚集的大的圆形至多边形细胞，核质比中等至低，胞质丰富、清亮均匀，核圆形至椭圆形，罕见双核至多核非典型细胞，伴有少量小淋巴细胞和/或中性粒细胞。肿瘤细胞表达CD1a、CD1c、CD11b、CD18和MHCII。抗CD3抗体识别出与肿瘤细胞混合的反应性T细胞。除1例病例外，其余病例均观察到E-钙黏蛋白表达。1例病例的TEM检查未发现伯贝克颗粒。
FPH是一种独特的肿瘤性病变，由非吞噬性组织细胞与中性粒细胞和小成熟淋巴细胞不同程度混合而成。必须进行CD1免疫细胞化学分析以确认树突状细胞起源。免疫细胞化学和细胞形态学有助于在细胞学样本上对FPH进行特异性快速诊断。
